Comparison of angled implants made by dynamic navigationand free hand method in dental implant surgery

Objective: In this study, it was aimed to analyze and compare the angular and planar deviation amounts of dynamic navigation and free hand implants. Materials and Methods: In our study, 100 implants were made to 25 models using Navident® (ClaroNav Inc., Toronto, Canada) system on a single surgen and 100 implants to 25 models using free hand technique.Totally 200 implants were made to of 50 models. 4 implants were made to each model and half of the implants were planned to be angled and half straight. Input deviation (2D), apical deviation (3D), vertical deviation and angular deviation values between the planned and applied implants for each implant made were evaluated with the Navident verification program Evalunav. Statistical analyzes were performed using IBM SPSS Statistics 25.0 (IBM SPSS Statistics for Windows, Version 25.0. Armonk, NY: IBM Corp.) program. Results: With the dynamic navigation device of Navident® (ClaroNav Inc., Toronto, Canada), the average input deviation in 50 axially upright implants is 0.89mm ± 0.35mm, and the average input deviation is 1.01mm ± 0.24mm in 50 implants planned as 30 ° inclined. When we look at the values of apical deviation, the average apical deviation was found to be 0.93mm (0.80mm-1.16mm) in 50 axially perpendicular implants, and the average apical deviation was 1.27mm (1.01mm-1.41mm) in 50 implants planned as 30 ° inclined. Vertical deviation values were found to be average vertical deviation of 0.19 mm ± 0.13mm in 50 implants that were axially perpendicular, and average vertical deviation of 0.30mm ± 0.15mm in 50 implants planned as 30 ° inclined. When we look at the angular deviation values, the average angular deviation was found to be 0.53 ° ± 0.28 ° in 50 axially implanted implants, and the average angular deviation is 0.94 ° ± 0.33 ° in the 50 implants planned as 30 °. When the group using the free hand technique is examined, the average input deviation in 50 axially perpendicular implants is 1.48mm (1.40mm-1.41mm), and the average input deviation is 2.20mm (1.95mm-2.57mm) in 50 implants planned as 30 ° inclined. When we look at the apical deviation values, the average apical deviation was found to be 2.12mm ± 0.19mm in 50 axially implanted implants, and the average apical deviation was 3.62mm ± 0.54mm in 50 implants planned as 30 ° inclined. Vertical deviation values were found as average vertical deviation 0.28mm (0.20mm-0.32mm) in 50 axially perpendicular implants, and average vertical deviation 0.39mm (0.28mm-0.48mm) in 50 implants planned as 30 ° inclined. . When we look at the angular deviation values, the average angular deviation was found to be 2.34 ° ± 0.53 ° in 50 axially perpendicular implants, and the average angular deviation was 6.73 ° ± 1.94 ° in 50 implants planned as 30 ° inclined. Conclusion: We have found that implants made with dynamic navigation can be made with higher accuracy compared to the free hand technique. Especially in apical deviation and angular deviation parameters, more deviation values were seen in free hand technique than dynamic navigation. Vertical deviation parameter showed almost same deviation values with dynamic navigation technique in free hand technique.